46 Years of Silence: Obstetric Fistula Keeps Kenyan Women Trapped in Stigma and Isolation

Alice Atieno spent almost half a century carrying a wound that no one spoke about. In 1980, a prolonged and obstructed labour left her with obstetric fistula — an abnormal opening between the birth canal and either the bladder or rectum — causing uncontrolled leakage that would define and diminish her life for 46 years.

The social cost was immediate and crushing. Neighbours kept their distance, unwilling to be near her. Her mother-in-law openly questioned her cleanliness, and the strain on her marriage proved too great: her husband eventually left for Nairobi, leaving Alice alone to manage both the condition and the shame it carried in her community.

For a time, she found a measure of comfort within a local church congregation. But that community actively discouraged her from seeking medical help, and so Alice remained silent — untreated and unseen — for decades.

Everything changed when she discovered that Jaramogi Oginga Odinga Teaching and Referral Hospital was offering free corrective surgery. The operation was a success, and the transformation was profound. "Today I can go to the toilet without fear or shame," she said after her recovery. "For the first time in many years, I feel human again."

Alice's experience is far from unique. Across Kenya, thousands of women are living with the same condition, many in silence just as she did. Among them: a 39-year-old woman who endured the condition for 17 years, and a 17-year-old student forced to wear diapers simply to attend school — both eventually accessing corrective surgery after years of stigma and social withdrawal.

Health experts are unequivocal: obstetric fistula is both preventable and treatable, yet Kenya still records roughly 3,000 new cases every year. Western Kenya carries a disproportionate burden, driven by poverty, limited awareness, and delayed access to emergency obstetric care. Over the past five years, Jaramogi Oginga Odinga Teaching and Referral Hospital alone has performed more than 3,000 repair surgeries, made possible in part by partnerships with the Safaricom Foundation and the Flying Doctors Society.

But surgery alone is not enough. Psychologists working with survivors emphasise that emotional recovery must accompany medical treatment. Women who have spent years absorbing shame and enduring exclusion require sustained support to rebuild their self-worth and reconnect with their communities. For Alice, after 46 years of silence, that journey has already begun — and for the first time, she is living it without shame.